In the majority of H. pylori-positive patients with profound hypochlorhydria the pathologic process has already progressed to an irreversible stage, find doctors in the June issue of Alimentary Pharmacology and Therapeutics.

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Profound hypochlorhydria is considered to be an important risk factor for development of gastric cancer. The long-term effect of Helicobacter pylori eradication on its reversibility remains uncertain.

In this study, doctors from Japan evaluated the change in acid secretion after eradication in 23 patients with profound hypochlorhydria.

Gastric acid secretion returned to normal range in 39%.

Alimentary Pharmacology and Therapeutics

The team performed an assessment of gastrin-stimulated acid output and a histologic evaluation of biopsy specimens before and 1 and 7 months after eradication.

In addition, the team assessed gastric acid secretion for a long-term period, more than 5 years, after eradication in 12 patients.

The doctors determined that gastric acid secretion returned to normal range in 39% of patients at 7 months after eradication.

They also found that the long-term follow-up group showed gradual and significant recovery in gastric acid secretion up to 2 years post-therapy.

However, there was no additional increase during the last 3 years of 5-year follow-up period. Acid secretory levels remained subnormal in the majority of the patients.

Dr Iijima and colleagues concluded, "This long-term follow-up study suggests that the pathologic process has already progressed to an irreversible stage in the majority of H. pylori-positive patients with marked body atrophy and profound hypochlorhydria".